![]() ![]() ![]() Initial encounters are described as active treatment (use letter “A” when assigning initial care codes) if the patient presents to the emergency department for a lacerated finger, the first listed code will end in the letter A to describe the initial active treatment by the ED provider if the patient then sees her Primary Care Physician (PCP) the next day, the first listed code will again end in the letter A because the injury is still undergoing active treatment and it will be the first encounter with that new provider (the PCP). Fracture care is an exception, and this will be addressed below, but first I want to describe the challenges coders face when trying to determine initial vs. The conditions found in Chapter 19 of the codebook are Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88) and most of these require the 7th character to identify the type of encounter. ![]() The 7th character represents the type of encounter, or phase of treatment this could be an initial encounter, a subsequent encounter, or a sequela (previously known as a late effect). The first character is alphabetical, followed by the next two numeric characters this first group of 3 characters represents the category, and this category group may be followed by a 4th, 5th, or 6th character for higher specificity. 2020 ICD-10-CM codes are all comprised of 3, 4, 5, 6, or 7 characters. ![]()
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